| NPI | 1336473305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM 0178361) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC47367) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2020-03-23 |